Panel’s Battles on Health Highlight a Broader Split

Thursday

Senate Democrats swatted down Republican attempts to make fundamental changes as the Finance Committee voted on amendments that highlighted the deep partisan divide over the bill.

WASHINGTON — Senate Democrats swatted down Republican attempts to make fundamental changes in their health care legislation on Wednesday as the Finance Committee voted on a wide range of amendments that highlighted the deep partisan divide over the bill.

The committee rejected an amendment offered by Senator Jim Bunning, Republican of Kentucky, that would have deferred a final committee vote until the panel had actual legislative language and a complete cost estimate from the Congressional Budget Office. The vote was 13 to 10.

Mr. Bunning’s proposal would have required the text of the bill and the cost estimate to be posted on the Internet for 72 hours before the committee voted on whether to send the bill to the full Senate.

“This bill will impact every American,” Mr. Bunning said. “It is too big and too important for us to rely on conceptual language and a preliminary estimate of cost.”

Senator Olympia J. Snowe of Maine, the one Republican who might eventually vote for the bill, supported Mr. Bunning’s proposal. “The American people are nervous about our attempt at health care reform and overhauling 17 percent of the economy,” Ms. Snowe said. “If it takes two more weeks, it takes two more weeks. What is the rush?”

The committee chairman, Senator Max Baucus, Democrat of Montana, agreed that a detailed summary of the bill, in plain English, and a complete cost analysis would be publicly available before a final committee vote.

Much of the debate Wednesday focused on the question of whether the bill would help or hurt older Americans in the Medicare program.

Over Republican objections, the committee voted to keep a provision of the bill that would establish an independent federal commission to help rein in the growth of Medicare, the insurance program for 45 million people who are 65 and older or disabled. The commission’s recommendations could take effect automatically unless Congress acted to achieve equivalent savings in other ways.

Senator John Kerry, Democrat of Massachusetts, accused the Republicans of “delay tactics.” Senator John D. Rockefeller IV, Democrat of West Virginia, said, “There is a substantial slow-walk taking place in this committee.”

Mr. Baucus said he hoped the committee would approve the bill this week, so it could be merged with a separate bill approved in July by the Senate health committee. The Senate majority leader, Harry Reid, Democrat of Nevada, said the full Senate could start debate early next month.

The White House is pressing Congress to speed action so President Obama can sign a major health care bill this year.

Senator Orrin G. Hatch, Republican of Utah, tested the patience of Democrats by peppering the committee staff with questions about the bill.

“If this were some itty-bitty bill, I could back off very easily,” Mr. Hatch said. “But this is not some itty-bitty bill. It could wreck the country.”

By contrast, Democrats described the bill as a long-overdue effort to guarantee Americans access to affordable health care.

The committee has yet to wrestle with some of the biggest, most contentious issues: whether to create a government insurance plan to compete with private insurers; whether to impose a new tax on high-cost insurance policies; whether to require individuals to carry insurance and employers to help pay for it; whether to provide additional subsidies to low-income people to help them buy coverage.

Senators have proposed amendments to address those issues and others, including abortion, illegal immigrants and medical malpractice.

Three Republican senators — John Ensign of Nevada, Jon Kyl of Arizona and John Cornyn of Texas — proposed several amendments to limit awards in malpractice lawsuits. Mr. Baucus ruled them out of order, saying the issue was not in the committee’s jurisdiction. His rulings were upheld on party-line votes.

The Finance Committee is meeting in a large hall, but most of the space is taken up by Congressional staff members and journalists. Just four rows at the rear, about 90 seats, are reserved for an audience, and a number have been empty.

For major legislation that could affect every American, the audience in the hall and milling outside has been smaller than might have been expected.

One reason is modern technology. Many lobbyists, journalists and others are watching the gavel-to-gavel proceedings on C-Span. And they can communicate with staff members and even senators by BlackBerry or other devices.

Technology has “taken the circus-like atmosphere away,” said John Jonas, a lobbyist with the Patton Boggs firm, which counts a variety of health care provider groups among its clients.

As a former employee of a member of the tax-writing Ways and Means Committee, Mr. Jonas contrasted the current scene with the crowds of lobbyists who filled that panel’s oversize hearing room and spilled into the halls.

Mr. Jonas said he continued to show up because the Finance Committee room was “still a good place to catch key staff” — and he was fresh off a conversation with a committee lawyer.

But he added, “A good lobbyist has done most of his work by now and doesn’t have to be clinging to the pant legs or the skirts of whomever they want to get time with.”

Never miss a story

Choose the plan that's right for you.
Digital access or digital and print delivery.